Medical

William Thomas Green Morton, American dental surgeon, in 1846 gave the first successful public demonstration of ether anesthesia during surgery. He is credited with gaining the medical world’s acceptance of surgical anesthesia.

Morton began dental practice in Boston in 1844. In January 1845 he was present at Massachusetts General Hospital, Boston, when Horace Wells, his former dental partner, attempted unsuccessfully to demonstrate the anodyne properties of nitrous oxide gas. Determined to find a more reliable pain-killing chemical, Morton consulted his former teacher, Boston chemist Charles Jackson, with whom he had previously done work on pain relief. The two discussed the use of ether, and Morton first used it in extraction of a tooth on September 30, 1846.

On October 16th, he successfully demonstrated its use, administering ether to a patient undergoing a tumour operation in the same theatre where Wells had failed nearly two years earlier. Morton named his “creation” Letheon, after the Lethe River of Greek mythology. Drinking its waters, the ancients contended, erased painful memories. Unfortunately, Morton attempted to obtain exclusive rights to the use of ether anesthesia. He spent the remainder of his life engaged in a costly contention with Jackson, who claimed priority in the discovery, despite official recognition accorded to Wells and the rural Georgia physician Crawford Long.

While many toyed with anesthetic agents, it was Morton who first developed a novel delivery instrument to enable ether inhalation during an operation. The device consisted of a glass flask with a wooden mouthpiece that could be opened and closed depending on the patient’s state of consciousness. This was critical because other experimenters, including Wells and Long, could not ensure rapid reversibility of the anesthetic state and often overdosed their patients. Morton’s genius resided not only in his observations of the power of ether but also in his development of a crude but scientific method of regulating its inhalation, thus creating the field of anesthesiology.

Conjoined twins are identical twins joined in uterus. A rare phenomenon, the occurrence is estimated 1 in 189,000 births, with a somewhat higher incidence in Southwest Asia, Africa and Brazil. Approximately half are stillborn, and a smaller fraction of pairs born alive have abnormalities incompatible with life. Siamese twins are formed from a single egg which develops into two almost separate balls of cells. In normal embryo and foetus development every cell knows where it is in the body because the neighbours produce chemical messages. So a skin cell knows not only it is skin, but that it is – say – nose skin, rather than chin or ear or lip skin. In Siamese twins these chemical messages don’t work properly. The end results can be very bizarre: a single organism with two heads, two hearts, four legs and arms – or is that single organism actually two people, two individual Siamese twins?

The most famous pair of conjoined twins was Chang and Eng Bunker (1815–1880), Thai brothers born in Siam, now Thailand. They travelled with P.T. Barnum’s circus for many years and were labeled as the Siamese Twins. Chang and Eng were joined by a band of flesh, cartilage, and their fused livers at the torso. In modern times, they could have been easily separated. Due to the brothers’ fame and the rarity of the condition, the term “Siamese twins” came to be used as a synonym for conjoined twins.

Surgery to separate conjoined twins may range from very easy to very hard, depending on the point of attachment and the internal parts that are shared. Most cases of separation are extremely risky and life-threatening. In many cases, the surgery results in the death of one or both of the twins, particularly if they are joined at the head or share a vital organ. This makes the ethics of surgical separation, where the twins can survive if not separated, contentious. The first such successful separation was carried out on 17th September 1953, at the Foundation Hospital, New Orleons, USA. Carolyn Anne and catherine Anne Mouton were separated in a three hour long operation.

At 8:15 a.m., August 6, 1945, a single atomic bomb erased an entire family. “The baby boy was safely born. Just as the family was celebrating, the atomic bomb exploded. Showing no mercy, it took all that joy and hope along with the new life.”

A little boy managed somehow to survive, but the atomic bomb took his entire family. This A-bomb orphan lived through hardship, isolation, and illness, but was never able to have a family of his own. Today, he is a lonely old hibakusha. “I have never once been glad I survived,” he says, looking back. After all these years of terrible suffering, the deep hurt remains.

The Atomic Bomb Survivors Relief Law defines hibakusha as people who fall into one of the following categories: within a few kilometers of the hypocenters of the bombs; within 2 km of the hypocenters within two weeks of the bombings; exposed to radiation from fallout; or not yet born but carried by pregnant women in any of these categories. As of March 31, 2013; 201,779 hibakusha were recognized by the Japanese government, most living in Japan. The government of Japan recognizes about 1% of these as having illnesses caused by radiation.

A woman who experienced the bombing at the age of 8 months suffered discrimination and prejudice. She did manage to marry, but a month later, her mother-in-law, who had been so kind at first, learned about her A-bomb survivor’s handbook. “‘You’re a hibakusha,’ she said, ‘We don’t need a bombed bride. Get out now.’ And with that, I was divorced.” At times, the fear of radiation elicited ugliness and cruelty. Groundless rumors caused many survivors to suffer in marriage, employment, childbirth—at every stage of life.

Indiscriminately stealing the lives of innocent people, permanently altering the lives of survivors, and stalking their minds and bodies to the end of their days; the atomic bomb is the ultimate inhumane weapon and an absolute evil. The hibakusha, who know the hell of an atomic bombing, have continuously fought that evil.

According to the decennial Indian census, the sex ratio in the 0-6 age group in India went from 104.0 males per 100 females in 1981, to 105.8 in 1991, to 107.8 in 2001, to 109.4 in 2011. The ratio is significantly higher in certain states such as Punjab and Haryana (126.1 and 122.0, as of 2001) Generally three principle causes are given for skewed ratio: female infanticide, better food and health care for boys and maternal death at childbirth. Prenatal sex determination and the abortion of female fetuses threaten to skew the sex ratio to new highs–with unknown consequences. Recognizing and seeking to control this perilous trend, the government of India outlawed prenatal sex determination on January 1st, 1996. The new law makes it illegal to advertise or perform the tests (with a few exceptions), and punishes the doctor, relatives who encourage the test and the woman herself with fines from ten to fifty thousand rupees and jail terms from three to five years.

Prenatal techniques for sex determination were introduced into India only in the early seventies. Although touted officially as an aid in reducing genetic defects, much of the Indian public has turned to these tests to find out if “It’s a boy” or not. Petitioning against sex selective abortions began in the 1980s, about fifteen years after the techniques of sex determination were widely introduced into the country. Maharashtra State was the only state which prohibited sex determination in 1988, but women used to go to other states where it was still legal. When commercial news of the tests became widespread, many women activists and health activists noticed them. Anti-selective abortion efforts grew to significance when it was discovered that even working class women and middle class women were using such tests. The efforts of such groups led to the parliament voting for ban on the test.

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Before 1978, women having Fallopian tube blockages had no hope of becoming pregnant. Dr. Patrick Steptoe, a gynecologist at Oldham General Hospital, and Dr. Robert Edwards, a physiologist at Cambridge University, had been actively working on finding an alternative solution for conception since 1966. Though Drs. Steptoe and Edwards had successfully found a way to fertilize an egg outside a woman’s body, they were still troubled by problems after replacing the fertilized egg back into the woman’s uterus. By 1977, all of the pregnancies resulting from their procedure (about 80) had lasted only a few, short weeks.

Lesley and John Brown were a young couple from Bristol who had been unable to conceive for nine years. Lesley Brown had blocked Fallopian tubes. On November 10, 1977, Lesley Brown underwent the very experimental in vitro (“in glass”) fertilization procedure. Using a long, slender, self-lit probe called a “laparoscope,” Dr. Steptoe took an egg from one of Lesley Brown’s ovaries and handed it to Dr. Edwards. Dr. Edwards then mixed Lesley’s egg with John’s sperm. After the egg was fertilized, Dr. Edwards placed it into a special solution that had been created to nurture the egg as it began to divide. Previously, Drs. Steptoe and Edwards had waited until the fertilized egg had divided into 64 cells (about four or five days later). This time, however, they decided to place the fertilized egg back into Lesley’s uterus after just two and a half days. Close monitoring of Lesley showed that the fertilized egg had successfully embedded into her uterus wall. At 11:47 p.m. on July 25, 1978, a five-pound 12-ounce baby girl was born. The baby girl, named Louise Joy Brown, had blue eyes and blond hair and seemed healthy.

Louise’s birth made headlines around the world and raised various legal and ethical questions. The Browns had a second daughter, Natalie, several years later, also through IVF. In May 1999, Natalie became the first IVF baby to give birth to a child of her own. The child’s conception was natural, easing some concerns that female IVF babies would be unable to get pregnant naturally. In December 2006, Louise Brown, the original “test tube baby,” gave birth to a boy, Cameron John Mullinder, who also was conceived naturally.

In 1880, a Parisian veterinarian sent Louis Pasteur samples from two dogs that had died of rabies. The number of rabid dogs had increased in Paris, and veterinarians had become concerned about the problem. Pasteur then began careful work on rabies, attempting to infect other animals with rabies and identify the site and cause of infection. Pasteur would continue to work with rabies over the next several years. In 1884, having tried to attenuate the rabies virus in monkeys, Pasteur turned to a different method to produce the vaccine. Pasteur predicted that drying of the infected tissue might weaken the virus. Pasteur was able to use a series of less-attenuated vaccines over several days to prevent rabies in dogs that had been infected. The work was dangerous: he and his assistants often had to handle the rabid animals and take samples from them. Pasteur announced to the French Academy of Sciences that he had successfully protected dogs from fatal rabies by use of his attenuated rabies vaccine.

On 6th July 1885, nine-year-old Joseph Meister was brought to Pasteur who was severely bitten by a rabid dog. Several factors made Pasteur’s potential involvement in the boy’s care controversial. Pasteur had never before successfully used the vaccine on a human. The concept of attenuation of viruses and bacteria was in its infancy at this time. Injecting a human with a disease agent, even a weakened one, was a new and controversial action. Pasteur was not a medical doctor and might have faced serious consequences had Meister not survived the injections. Pasteur felt certain that the boy would die from rabies infection if he did nothing. So he began the course of 13 injections, one each day, of vaccine made from rabbit nervous system tissue. Each successive injection contained a less-attenuated (stronger) virus.

Meister never developed rabies, and the incident was regarded as a success. Later in life, Meister worked as caretaker of Pasteur’s tomb at the Institut Pasteur in Paris.

For many centuries, smallpox devastated mankind. In the 18th century in Europe alone, 400,000 people died annually of smallpox, and one third of the survivors went blind For many years. The word variola was commonly used for smallpox and is derived from the Latin word varius, meaning “stained,”. Edward Jenner, a medical practioner, had heard the tales that dairymaids were protected from smallpox naturally after having suffered from cowpox. Pondering this, Jenner concluded that cowpox not only protected against smallpox but also could be transmitted from one person to another as a deliberate mechanism of protection.

In May 1796, Edward Jenner found a young dairymaid, Sarah Nelms, who had fresh cowpox lesions on her hands and arms. On May 14, using matter from Nelms’ lesions, he inoculated an 8-year-old boy, James Phipps. Subsequently, the boy developed mild fever and discomfort in the axillae. Nine days after the procedure he felt cold and had lost his appetite, but on the next day he was much better. In July 1796, Jenner inoculated the boy again, this time with matter from a fresh smallpox lesion. No disease developed, and Jenner concluded that protection was complete.

In 1797, Jenner sent a short communication to the Royal Society describing his experiment and observations. However, the paper was rejected. Then in 1798, having added a few more cases to his initial experiment, Jenner privately published a small booklet on the subject. The Latin word for cow is vacca, and cowpox is vaccinia; Jenner decided to call this new procedure vaccination. Jenner conducted a nationwide survey in search of proof of resistance to smallpox or to variolation among persons who had cowpox. The results of this survey confirmed his theory. Jenner’s work represented the first scientific attempt to control an infectious disease by the deliberate use of vaccination. Strictly speaking, he did not discover vaccination but was the first person to confer scientific status on the procedure and to pursue its scientific investigation.